Random thoughts from a few cantankerous American physicians. All contributors are board certified. Various specialties are represented here. I do not know where this will lead but hope it will at least be an enjoyable read. All of the names mentioned in this blog are pseudonyms, the ages have been changed, and in half the cases the gender as well. All photographs are published with patient consent or are digitally altered to preserve anonymity. Trust us, we're doctors.

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Sunday, February 10, 2008

I need to see something funny. The few posts have been too serious, so...

Some years ago I saw a 20ish year old guy who's CC was "penile problem". When I pulled back the covers this "dickhead" (pun intended) had placed a 10lb cast iron weight upon his erection to, uhh, work it out and build strength. Well, its on the base of his pecker and he had a semi-erect penis that was still too engorged to allow manual removal!

He had to go to the OR for removal of the plate from his tool. It took 4 saws to get thru the plate and he had no permanent damage(unfortunately)..

how did they cut through the plate without burning the thing to a crisp? had a guy two years ago that got a piston ring stuck on his johnson-rod. a real puzzler because the heat transfer with a powered saw etc... had one of our ortho guys happen thru the ED and he got it off with some bolt cutters as the ER doc carefully kept the important parts away from the jaws of the cutters with a couple of tongue depressors. we gave him the 'consultant of the quarter award' for operating on a differnt kind of bone.

24 hour boner? Is that unusual? When I was 10 I heard someone say masturbation would make you go blind. Thats me with the -6.5 coke bottle lenses, haven't got LASIK yet cause Dr. Evil has the only Laser big enough.

had a guy, doesn't really matter what his sexual orientation was but from the following you might guess... took some of his friend's 'caverject'... a super high potency boner-producing medicine. you actually have to inject a bit into the corpus cavernosum at the base of the penis. turns out that this stuff works for people with absolutely dead willies, his wasn't dead and sprang right to attention. i think he had a blast for about 6 hours then it began to hurt and 24 hours later he was in the ER, the urologist and i had two butterfly needles in the base of his rigid manhood, in one side went normal saline and neosynephrine and out the other we pulled blood. didn't work. packed it in ice. didn't work. to the OR for a shunt. good idea dude. hope it was worth it.

dear frylime, a great question! it wont work. the venous drainage of the penis is mostly peripheral so if the penis becomes engorged and there is a ring blocking venous return then the boner won't go away. hence the need for removal or the johnson-rod necroses and falls off.

with the chemical called caverject there's just no way to cure the priapism, which is a medical emergency for the reasons above, if the 'easy' stuff fails. surgery.

The "servicing" wouldn't have worked for this kid. We think it had to do with his sickle cell trait.

We tried the neo-synephrine and saline, and it went down...but then it came right back up. We packed it in ice. Nope. Poor dude. He was being a real asshole to all the nurses, too, so it was very hard to feel sorry for him but heck, his weiner was turning black.

Speaking of Peni, I fondly remember my cadaver, "Dr. Funk", a powerfully built, well endowed, African-American gentleman in his 50's when he left this mortal coil. The embalming staff had outdone themselves with Dr. Funk who appeared to be peacefully napping on the dissecting table. Mary Ellen was a classmate, a petite blonde graduate of an elite southern university, and former sorority president. When it came time to study Dr. Funks male areas, a disgusted look came over her face, excentuating her already perpetually turned up nose, as she said "Are they all this big"

the new religion of diversity forbids such value judgements. we, under the new religion, actually value people like this more than 'normal' people as 'normal' people do not contribute to diversity. in fact, 'normal' people should be sterilized... then, of course, normal becomes fucked-up, and fucked-up becomes normal. hmmmmm. puzzling.

PS I saw swollen, cellulitic and necrotic balls on a diabetic the other day. That was lovely. He waited in the waiting room 3 hours then got back, and about 2 hours later was tubed with no blood pressure. Always come in BEFORE your balls turn black.

85, I was so traumatized by looking at it, I almost went "Heath Ledger" :-)I believe the Urologist had to in the Orthopedist because he did'nt know what type of "tool" to use to cut thru the 1/2" solid steel plate!

OldFart! I KNEW that would be the worst part for you! LOL! Does your new fancy ER have one of those eye-wash stations? Maybe you can wash out the image?!?!?!I bought a house today that I can't WAIT to show you! More on that later.

Frylime said: "why couldn't he just service himself to get the thing off?" Maybe he's not as flexible as the rest of us? Just sayin'.

Has anyone ever pulled the "Mike Hunt" prank? It has to be a busy clinic, or office setting where patients/customers are called by their names. You ask the habitat for humanity chick to go see if Mike Hunt is out there for his methadone prescription/etc. I had it pulled on me as a student.

Here's a good one, I'd be surprised if you haven't already heard it.Write the following down on a piece of paper and hand it to someone who can take a joke and ask them to read it out loud. An anaesthesiologist once had us howling with laughter cause it took him so long to get it we thought, he must be kidding. He wasn't.I am sofa king. We Todd did.

and his brother phil mcckraken, and a guy from africa, haywood d'jiblomi,and the two irish homosexuals, hugh fitzpatrick and patrick fitzhugh, and dick hertz,and miles long, and.... shit, back in 7th grade again.

Speaking of Pranks, the attendings on the 3rd year Psych rotation were big on demanding complete physicals on new patients, I guess to prove they were real doctors. Of course they sort of showed they weren't real doctors by insisting we do every possible test. The Hemmocult cards were kept behind the Nursing station. One morning, a student came out of a room, apparently with a smidgen of stool on his gloved finger, in search of the hemmocult card he had neglected to take in the room. Not being to find the card, he turned to a fellow student, a particularly frigid female, and asked if she thought it looked heme positive. When she failed to answer he stuck the finger in his mouth and said, "negative" as she scurried away horrified. Of course, it was chocolate, not stool. I see her occasionally, still a frigid bitch, just older. She still thinks my friend ate shit to freak her out.

I had a diabetic with necrotic "tools" and all was basically removed...pt was back from surgery like 2 hrs when I came onshift and checked him...he was bleeding ... perfusely!@!!! I called the doc...and he said apply pressure...and I'm like "where???" since basically it looked like innards and was horrifically painful!!!! The doc didn't want to come in, but 15 minutes later he was there and the guy was back down to surgery...again.

In his 13-page decision in David McKee, M.D. v. Dennis K. Laurion (Docket No. A11-1154), Minnesota Supreme Court Justice Alan Page reversed a court of appeals ruling and sided with the trial court that originally dismissed a neurologist's defamation claim against the son of a stroke patient he treated who had posted negative remarks about the plaintiff on a rate-your-physician Web site.

The Minnesota High Court heard oral arguments four months ago (see "TUOL" post 9/5/12) in the case brought by Dr. McKee of Northland Neurology & Myology in Duluth against the son of a 65-year-old stroke patient he treated concerning a half-dozen allegedly actionable statements reflecting the son's dissatisfaction with the medical care provided and his belief that Dr. McKee was rude and insensitive.

The lightning rod among the allegedly offensive statements was a post by the defendant that said: "When I mentioned Dr. McKee's name to a friend who is a nurse, she said, 'Dr. McKee is a real tool!'" "Referring to someone as 'a real tool' falls into the category of pure opinion," Justice Page wrote, "because the term 'real tool' cannot be reasonably interpreted as stating a fact and it cannot be proven true or false." Characterizing the remark as "rhetorical hyperbole" and "mere vituperation or abuse," Justice Page said it could not support a defamation action as a matter of law.

The devoted "TUOL" staff supports the Minnesota Supreme Court's decision and the principle that pure opinion is not susceptible to a defamatory meaning, but questions whether bringing a lawsuit such as the one at issue in the first place is sufficient proof of "tooldom" in and of itself.